Extensive tissue damage of bovine ovaries after bipolar ovarian drilling compared to monopolar electrocoagulation or carbon dioxide laser
The results from this paper were presented at the American Society for Reproductive Medicine meeting in San Francisco, California, 2008.
Received 7 August 2008; received in revised form 20 October 2008; accepted 24 October 2008. published online 18 December 2008.
Objective
To evaluate the size of ovarian damage caused by ovarian drilling in polycystic ovary syndrome, the amount of inflicted damage was assessed for the most frequently used ovarian drilling techniques.
Design
Experimental prospective design.
Setting
University clinic.
Patient(s)
Six fresh bovine ovaries per technique.
Intervention(s)
Carbon dioxide (CO2) laser, monopolar electrocoagulation, and bipolar electrocoagulation were used for in vitro ovarian drilling.
Main Outcome Measure(s)
Amount of inflicted ovarian damage per procedure.
Result(s)
Bipolar electrocoagulation resulted in significantly more destruction per burn than the CO2 laser and monopolar electrocoagulation (287.6 versus 24.0 and 70.0 mm3, respectively). The damage found per lesion was multiplied by the regularly applied number of punctures per procedure in daily practice (based on the literature). Again, the bipolar electrocoagulation resulted in significantly more tissue damage than the CO2 laser and monopolar coagulation (2,876 versus 599 and 700 mm3, respectively).
Conclusion(s)
Ovarian drilling, especially bipolar electrocoagulation, causes extensive destruction of the ovary. Given the same clinical effectiveness of the various procedures, it is essential to use the lowest possible dose that works; thus, the first choice should be CO2 laser or monopolar electrocoagulation.
aDivision of Reproductive Medicine, Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, The Netherlands
bDivision of Pathology, VU University Medical Center, Amsterdam, The Netherlands
Reprint requests: Marja-Liisa Hendriks, Department of Obstetrics and Gynaecology, Division of Reproductive Medicine, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands (TEL: +31.20.4443268; FAX: +31.20.4443267).
M-L.H. has nothing to disclose. P.V. has nothing to disclose. C.L. has nothing to disclose. M.B. has nothing to disclose. R.H. has nothing to disclose. P.H. has nothing to disclose.
ABSTRACT